John Cleland - Woodrow Wilson International Center for Scholars

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Fertility Trends, 1950-2005: Selected. Developing Regions. 2. 3. 4. 5. 6. 7. 8. 1950 1955. 1960. 1965 1970. 1975 1980. 1985 1990. 1995. 2000. T o ta l F e rtility.
A Job Half Done: Family planning in the 21st Century John Cleland London School of Hygiene & Tropical Medicine

Population Growth Rate 1950-2005 2.5

Growth Rate

2 1.5 1 0.5 0 1950

1960

1970

1980

1990

2000

2010

Fertility Trends, 1950-2005: Selected Developing Regions 8

7 Sub-Saharan Africa

Latin America &

Total Fertility

6

the Caribbean Asia Northern Africa

5

4

3

2 1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

Increase in Population by Decade, in Millions 1000

Millions

800

600 LDCS MDCS 400

200

0 1750

1800

1850

1900

1950

2000

2050

Estimated Population, 2005 and Projected Population 2050, in millions Sub-Saharan Africa North Africa Latin America Asia Northern America Europe

2005 751 191 561 3905 331 728

2050 1692 312 783 5217 438 653

Ratio 2.25 1.63 1.39 1.34 1.32 0.90

World

6465

9076

1.40

Source: UN Population Proj. 2004

Mean Unwanted Fertility Rate by wealth quintiles (n = 19 non-African Countries) 1.65 1.36 1.08 0.83 0.48

Poorest (adapted from Gillespie et al, 2007)

Richest

African Fertility Trends (Past & Projected) 8 7 6 5 4 3 2 1

19 60 19 70 19 80 19 90 20 00 20 10 20 20 20 30 20 40 20 50

0

East Africa Middle Africa Southern Africa Western Africa

Percentage of currently married women using a modern method of contraception: West Africa PERIOD Country

197579

Benin

198084

198589

1990 -94

1

Burkina Faso

4

Chad Côte d'Ivoire

1

4

199599

2000+

Policy to Reduce Fertility

3

7

-

5

9

3

1

2

-

Gabon Ghana

6

4

Guinea Liberia

6

Mali

1

Mauritania Nigeria Senegal Togo

1 1

2 3

12

-

10

13

19

3

5

4

6

3 3

5

0

Niger

3

7

6

3

5

-

2

5

5

3

4

9

8

3

5

8

10

3

7

9

-

Mean desired family sizes among all women (African surveys) PERIOD Country Benin

1975-79

1980-84

1985-89

1990-94

7.4

Burkina Faso

5.7

1995-99

2000+

5.5

4.9

5.7

5.6 8.9

Chad Côte d'Ivoire

8.4

5.5

5.4 4.9

Gabon Ghana

6

5.3

4.4

Guinea Liberia

4.3

4.4

5.7

5.6

6.6

6.2

6

Mali

6.9

Mauritania

6.2

Niger Nigeria Senegal Togo

8.3 8.3

6.8 5.3

8.2

8.2

5.8

6.1

6.7

5.9

5.3

5.4

4.5

Niger Population (2005)

14 million

Total Fertility Rate

7.1 births per woman

% using modern contraception

5%

Life expectancy

45.4 years

Infant mortality

81

Adult literacy

16%

% child stunted

38%

HIV prevalence

0.7%

Projected population in 2050 if (a) Fertility remains constant

80 million

(b) Fertility declines to 3.6 by 2050

50 million

Kenya: Changes in Reproductive Indicators 1977-78

1984

1989

1993

Mean desired family size

7.7

6.2

4.7

3.9

% wanting no more children

16%

N/A

49%

52%

% contracepting

7%

17%

27%

33%

8

7.7

6.7

5.4

Fertility rate

Success in Kenya:1980-95 • • • •

Strong political support Mobilisation of elite groups Extensive use of mass media Access to FP methods via health facilities, social marketing and community distribution • Adequate international funding

Trends in total fertility rate and contraceptive use in married Kenyan women 10

35%

9

30% 25%

7 6

20%

5 15%

4 Fertility Rate

3 2

10%

Contraceptive Use

5%

1 0 1975

1980

1985

1990 Year

1995

2000

0% 2005

Contraceptive Use (%)

Fertility rate per woman

8

KENYA: CAUSES & CONSEQUENCES OF FERTILITY STALL CAUSE(?) Between 1995-2005 USAID’s Annual allocation for family planning fell from $12 million to $9 million while HIV/AIDS allocation rose from $2 to $74 million CONSEQUENCES: % unwanted births rose from 11% (1998) to 21% (2003) and % contraceptive users relying on public sector supplies fell from 68% to 53% KENYA’S PROJECTED POPULATION IN 2050 RAISED FROM 44 TO 83 MILLION

DISTRIBUTION OF 76 LOW AND LOWER-MIDDLE INCOME COUNTRIES BY RATE OF POPULATION GROWTH AND UNMET NEED FOR FP Unmet Need Low (